Sex, Race, and Geography Influence Health

Sex, Race, and Geography Influence Health

The researchers did not expect women to show the worst health outcomes because their viral loads were lower and CD4+ T cell counts were higher than men's following diagnosis, reported study author Doctor Amie L. Meditz, of the University of Colorado- Denver.

However, during the course of the study (1997-2007), the frequency of HIV-related illnesses in women was more than double that of men, with nonwhite women having the most negative outcomes. After eight years of infection, HIV-related events affected 64 percent of nonwhite women, and AIDS-defining events occurred in 22 percent of nonwhite women. In comparison, HIV-related and AIDS-defining events occurred in 21 percent and 6 percent of individuals in other combined race and sex groups, respectively.

The data representing subjects from the southern U.S. show that race and region play a major role in health outcomes of both women and men infected with HIV. Eight years following their diagnosis, 78 percent of nonwhites and 37 percent of whites in the southern U.S. had experienced one or more HIV/AIDS-related event, compared to 17 percent of nonwhites and 24 percent of whites in other geographic locations.

According to the investigators, race-sex differences in response to antiretroviral therapy were nonexistent. The researchers observed that nonwhite women and men and individuals from the South were not as likely as white men and individuals from other regions of the U.S. to initiate antiretroviral therapy. Nevertheless, use of antiretroviral therapy only explained part of the differences in outcomes. The authors hypothesized that the disparities could be attributed to the influence of socioeconomic factors, including "access to health care, health behaviors, lifestyle, and environmental exposures." Delayed therapy may be one factor affecting increased morbidity in HIV-infected individuals living in the South; however, socioeconomic factors probably also play a role.